Dr. Dan Egan is currently an emergency physician and the Program Director of Emergency Medicine at Mount Sinai St. Luke’s Roosevelt. Although a large amount of this time is split between clinical duties and academic responsibilities, Dr. Egan still manages to create a balanced environment by knowing his limits and exploring life beyond medicine. He has effectively found a way to include wellness into his everyday schedule, so that he always has time to reflect and decompress. Here’s how he stays healthy in EM!

• Name: Dan Egan
• Location: New York
• Current job(s): Program Director, Mount Sinai St. Luke’s Roosevelt
• One word that describes how you stay healthy: Balance
• Primary behavior/activity for destressing: Music

What are the top 3 ways you keep healthy?

1. Sleep. As I have progressed in my career, and I look around at many of my colleagues who I think are incredibly successful, I have noticed that there are many people who do not stress the importance of sleep. It truly is a time when we can recharge and allow our brain to have that complete rest. It is tempting to always try to complete the “to do list” by the end of the day, which can lead to staying up late or getting up early. However, to me, there is nothing worse than that feeling of being chronically tired. So, I have to force myself sometimes, but especially since becoming a program director, I make sure that I am getting enough sleep. Our job is challenging enough with the variation in our sleep cycles, so it’s important that we take care of ourselves.

2. Balance. This really is critical to me. For all of the serious career and professional development things that I do, I try really hard to maintain balance outside of my job. This is easy to say, but I have found that you need to be proactive about these things. So for me, there are a number of things that I do in order to get work out of my brain, and remind me of what is going on in the rest of the world. Probably the most important thing to me is my involvement in a large chorus in NYC. I have rehearsal every week and during that time there is no medicine on my mind. It gives me a chance to be surrounded by people that for the most part, are NOT in medicine. I also definitely have my share of non-medical shows on the DVR, which give me a chance to just check out for a while. And lastly, I make it a priority to ensure that I have social events on my calendar even it it’s just a simple dinner with friends. I’m lucky to live in NYC so there are plenty of opportunities around me.

3. Exercise. This definitely has changed for me in the last several years. I was never good at this, and more recently I have made this a priority. I am not the kind of person who is up every morning for a run before going to the office, but I do have a personal trainer and this forces me to put it on my calendar and block out time for my health. It’s a little more expensive this way, but I think the investment is important.

What’s your ideal workout?

Tricky answer. I really love my sessions with my trainer. It’s different each time and I don’t get bored. I’m too easily distracted if I plan my own workouts and I don’t get creative. I find doing cardio is ok, but pretty boring unless I’ve got a good podcast or show to watch. That being said, I try not to listen to EM related podcasts while at the gym, because it just adds to the idea that I’m allowing myself to be consumed by my job.

Do you track your fitness? How?

It depends on how I’m feeling about myself. When I feel myself sliding and not being as healthy as I should, I do start tracking fitness and nutrition. I use any of the free apps on the iPhone to do this. Most of the time, though, I’m just making sure I keep things on my calendar.

How do you prepare for a night shift? How do you recover from one?

Preparation: My routine usually involves waking up early on the day of a night shift, and minimizing my caffeine intake during the day. This allows me to be really tired by late afternoon/early evening and able to take a nap. A two hour (sometimes three) snooze right before a night shift really gives me the extra boost to get through the night. I make sure I caffeinate on the way into work, to keep me focused through the night.

Recovery: Recovery is a lot harder as I get older (and I’m not even that old). I used to be able to come home, sleep all day, wake up, and start again. It’s harder for me to sleep during the day now. So things that help me are white noise and a dark room. I typically can only now sleep for about 5 hours and so I wind up going to bed early that night. It feels like I lose a day in many ways, but it helps me recover more quickly. After I wake up, I find that if I stay home and don’t do anything it’s harder to recover, so it’s important to force myself to go outside and do something.

How do you avoid getting “hangry” (angry due to hunger) on shift?

I’m spoiled when it comes to this. I work in a department where we have scheduled breaks on our shifts, so we can go outside and eat. It’s the only place I’ve ever been where that occurs and honestly it just makes sense. It’s not normal to expect people to go ten hours without eating or drinking (thank you, JCAHO). It’s even more important since we can’t have food or drink at the desk. So we get to leave the department and even the hospital, to spend 45 minutes taking care of basic human things. It’s incredible how much it helps, when you give yourself the chance to re-fuel and reset mentally. And when we return, there are usually only four or five hours left in the shift and it’s easy to get through. I’ll be honest, when I have worked in places where we didn’t have a break, I still always ate. Taking a quick break, even for 10 or 15 minutes, to eat and decompress just makes sense, and it definitely keeps me from becoming hangry!!

How do you ensure you are mentally in check?

I use my friends for this. I have a great group of friends that ground me and keep me in check. I also have a great professional network of colleagues and friends from different stages in my career who are sounding boards for me when things aren’t perfect — like when I have a bad case, or I’m having a challenging situation as program director. It’s good to have people in your life who aren’t afraid to tell you when you don’t seem ok — good friends, partners, kids.

What are the biggest challenges you face in maintaining a longstanding career in EM? How do you address these challenges?

I think for most of us, the biggest challenge is the clinical environment. It’s increasingly more challenging to do all of the things expected of us: see patients immediately, achieve incredibly high patient satisfaction scores, never miss any details while doing things rapidly, follow guidelines put upon us by external sources, and have a zero percent error rate. It’s an impossible job as I was advised. But we all strive to achieve these goals. I have addressed this challenge, by finding things outside of the clinical environment which make me happy. I love the work that I have done academically and now my work as a residency director. Ultimately, I chose to take care of patients. So I never want to be in a situation where I feel like work is a burden. By taking on administrative duties, I decrease my clinical hours, which keeps me from feeling burnt out in the clinical environment. It is so satisfying to love practicing medicine and honestly, for me, it’s easier that it doesn’t happen as often, but frequent enough that it reminds me of why I chose EM.

Best advice you have received for maintaining health?

Mark Clark, the PD before me at MSSLR, always said that one of the most important things to maintain wellness is to take time for yourself every single day. He went so far as to say that each day, it is critically important to have time where you are alone and silent, to just be present with yourself. We are the constant caregivers in our profession, and we so often forget to take care of ourselves. I’m not good at just shutting things off on a regular basis, but when I do, I feel so much better about myself and things in general.

Who would you love for us to track down to answer these questions?

Megan Fix
Taku Taira

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The post I am Dan Egan, EM Residency Program Director at St. Luke’s-Roosevelt: How I Stay Healthy in EM appeared first on ALiEM.